I dragged myself out of bed to discover that my voice had become a whisper. It was my turn to say the morning prayer and I happily passed the honor to Dr. Jim who eloquently filled the bill. I have no trouble with public speaking, but for some reason I find it hard to speak to God in front of an audience.
The day was cool and windy, but the line outside the church was long and welcoming. We went to work without the usual bumbling about, having now created a system that took advantage of everyone's skills. Docs and Spanish-English translators went straight to their stations. Runners guided patients through triage to the waiting areas and placed their papers in a docket on the wall. Quechua translators went from one clinic space to another, on call- and seemed to appear exactly when we needed them. Downstairs, the pharmacy- in a constant state of motion - received prescriptions and carefully prepared packages for patients who went to Integrated Health before receiving their meds. Integrated Health is a classroom of sorts where patients learn how to deal with their personal concerns, how parasites are transferred and how to stop the cycle, how to strengthen one's back to prevent strain, healthy ways to eat, child care, birth control and psychiatric help.
I wondered at first how our two psychiatrists would handle emotional concerns when we were there for such a short time. The answer was soon evident. Alcoholism, thoughts of suicide, spousal abuse and endless poverty were things people wanted, needed to talk about. It didn't take long for Drs. Jim and Paul to find themselves quite busy.
Pam and I spent a long time with two young women who really needed to talk. Both had chronic illnesses and I saw for the first time how devastating this can be to people who would normally be enjoying their youth, their friends and their education. Both felt left out, worthless, betrayed by their bodies. They wanted a cure or a way out! Suggesting antidepressants wasn't enough. Pam sent them to see the professionals downstairs and arrangements were made for them to have follow up care.
Most of the patients Pam and I saw were women - and one I will always remember is the beautiful young mother who, after her appointment, agreed to show us how she wrapped her baby so that he could be carried on her back. So many women carry their babies this way and it amazed me to see how they maneuvered around corners, or in and out of buses and cars without bumping the infant's head or feet. They are so intimately aware of the size and position of their bundle that accidents don't seem to happen. Her baby boy was a beauty and sound asleep when she began to unwrap him. He awoke as she showed us the shape and size of the shawl. She told us where to buy the same shawl and said that she would now have to show us the "awake" way of wrapping. She placed him in the richly coloured fabric, turned the edges this way and that, bent over and slung the little one over her shoulder all in one fluid movement. He was suddenly peeking over her shoulder, his dark eyes shining and eager to go. Pam and I were as enchanted with the lesson as we were with her and we wished we didn't have to hustle to the next patient and let her go.
[Image: Mother with child.]
This day went by more quickly than the last. Now a cohesive unit, we took apart in short order the clinic we had so neatly put together, packed the bags and were preparing to leave when something stopped us all. Near the side entrance to the church, a small and earnest group had formed a semicircle around a young mother of three. She was perhaps 25. She had two little girls and a newborn. The baby, 7 days old, lay on the bench beside her. It had not been fed. It was thin, listless, quiet. One of the nurses was explaining to the mother that she had to feed her baby or it would die. The translator had tired of waiting for the nurse and was admonishing the woman saying, "Do you want to be responsible for your baby's death? Don't you want to save this baby?" The woman's eyes were open, but she looked at nothing. Her eyes were without expression; completely blank... Her body was still rounded from having given birth, but her breasts were flat, her face gaunt and colourless. Her other daughters, ages perhaps 4 and 7, were being hugged by two of the volunteers. They watched but also with little expression. It was as if they were deaf to all that was going on around them. The nurses became frantic. The baby's condition was grave. Any decision involving the baby would have to be taken away from the mother. The baby would go to the hospital where it would have a feeding tube, where it would get treatment and hopefully survive.
Liuba and I continued to help pack up the pharmacy and carry the supplies outside. We could do nothing and the fewer people in the area, the better. Outside at the bus, Liu was distraught. The scene we had just witnessed had been awful. It occurred to me that we had seen so many women left with children they had to raise alone, with no money and no support and this one had just given up. What was there to celebrate in this new birth? More responsibility, more need, more hunger. What I saw in her eyes was beyond desperation. She had lost the will to care.
The small, cluttered shops passed by under the windows of the bus, now recognized - a landmark here, a sign there. We were becoming familiar with the way back to the hotel and glad to retreat to our rooms, wash up, and reassemble downstairs. After dinner, we again went through the events of the day. A tally was made of the number of patients we had seen, how much medication had been given out. We were low now on certain antibiotics, arthritis meds and nose spray. We still had plenty of eye drops, cough medications cortisone shots and antacids. Some supplies could be replenished from a storehouse maintained by MMI in Peru, but was there time to get it? For those of us who were simply there to help, it was an easy few days of work. The organizers however were constantly busy, handling everything from dietary preferences to the loss of a passport to the recuperation of medical supplies. We were constantly amazed by their efficiency and consistent good humor. Those of us 45 and older usually went to bed around 9, but the younger people sang, talked or went off into town for some fun. Even the evenings were routine - and it took less than a week to make us all a bit "predictable". As I waited for the cold medication to ease my stuffed head into sleep, I thought about how close we'd all become and how quickly we'd be leaving. Tomorrow, the last clinic.
[Image: MMI Volunteeers on a bus.]
- Wow. This is almost touching. Almost. Five bucks says that Lynn drew the wrong conclusion from the second mother. I see a mother who might be as badly off as her child; Lynn and the idiots screaming at her see something bad.